Individual
CHARLOTTE MOORE MAULL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 VOLVO PKWY, STE 202, CHESAPEAKE, VA 23320
(757) 312-8550
(757) 312-8553
Mailing address
760 LYNNHAVEN PKWY, STE 201, VIRGINIA BEACH, VA 23452
(757) 306-4232
(757) 306-4235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701001746
VA
101YM0800X
Mental Health Counselor
Primary
0812000813
VA
106H00000X
Marriage & Family Therapist
0717000828
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265827
BCBS
VA
05
—
5410738
—
VA
Enumeration date
09/20/2005
Last updated
09/11/2025
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